Postimplantation Syndrome after Endovascular Aneurysm Repair

Abstract

Endovascular aneurysm repair is associated, in a significant proportion of patients, to a systemic inflammatory response denominated postimplantation syndrome (PIS). PIS is characterized by fatigue, fever, and a rise in inflammatory biomarkers after the operation. However, the exact definition is still a matter of debate. There are several proposed definitions for PIS in the literature resulting in significant vari- ability of PIS incidence (ranging from 2% to 100%). The etiology of PIS is not entirely clear. Endograft composition, aortic thrombus, intestinal bacterial translocation, and contrast media may contribute to PIS but the first seems to be the most important determinant. This clinical entity may have clinical consequences in length of hospital stay, readmissions, renal function, cardiovascular events, endoleak rate, and quality of life, but current data are insufficient for definitive conclusions. Despite of absence of stablished treatment for PIS, non-steroid and steroid anti-inflammatory drugs are currently advocated when clinical suspicion arises. Prevention may be achieved with perioperative administration of a steroid drug. Since it may have adverse effects, further knowledge of the real incidence of PIS and its clinical consequences is imperative.